This study's purpose was to examine relationships among dental anxiety, psychological functioning, coping, and pain perception in child and adolescent dental patients and their parents. Participants were recruited from private dental offices and included 129 9- to 15-year-old patients and 84 parents. The children completed self-report measures of dental anxiety, dental coping, and pain perception, while parents completed self-report measures of dental anxiety, dental coping, and child's psychological functioning. The intraclass correlation coefficient method was used to examine each hypothesis. For child-ren, correlational analyses indicated positive relationships between dental anxiety and total psychological symptoms, and dental anxiety and pain perception. Both child and parent coping measures were examined using principal axis factor analysis. Clear 2-factor structures (ie, approach and avoidant-based coping factors) emerged. The children's approach-based coping was negatively related to both dental anxiety and pain perception; their use of avoidant-based coping was also negatively related to dental anxiety. Psychological functioning emerged as a mediating variable between dental anxiety and pain perception. The findings suggest that dental professionals and clinicians should consider dental anxiety and general psychological functioning to reduce pain perception in the office. Additionally, the child's coping type and approach should be considered in treatment planning.